Objective： To observe the clinical effect of the external application of Huangting powder com bined with anti-tuberculosis medicine for tuberculous exudative pleurisy.Methods：Divided 192 cases of patients with tuberculous exudative pleurisy admitted in our hospital into the observation group and the controlgroup randomly，96 cases in each group.The observation group received such treatments as external application of Huangting powder ，standardized anti-tuberculosis and thoracentesis aspiration，while the control group was given treatments including standardized anti-tuberculosis and thoracentesis aspiration.The two groups received treatment for two courses，one months being a course.During treatment，observed the clinical effect，the total absorption rate of pleural effusion，the concentration of tumor necrosis factor α(TNF-α )and transforming grow th factorβ 1(TGF-β 1)in pleuraleffusion，and the incidence of complications in both groups.Results：After one course of treatment，the totaleffective rate was 93.6%in the observation group and 83.3%in the control group，difference being significant( P ＜0.05).After two courses of treatment，the total effective rate was 96.8%in the observation group and 91.7%in the controlgroup，difference being insignificant( P ＞ 0.05).After treatment，the concentration of TNF-α and TGF-β 1 in the observation group was significantly lower than that in the control group，differences being significant( P ＜0.05).The total absorption rate of effusion was 76.6%in the observation group and 62.5%in the control group，difference being significant( P ＜0.05).The incidence of encapsulation and adhesion of pleuraleffusion was 6.4%in the observation group and 15.6%in the control group，difference being significant( P ＜0.05).Conclusion：Compared with the simple application of anti-tuberculosis medicine，the external application of Huangting powder com bined with anti-tuberculosis medicine for tuberculous exudative pleurisy can enhance the clinical effect，and improve the level of inflamm atory factors in effusion.